Loading...
 

Dehydration/Vomiting/Diarrhea


Diarrhea can be accommodated in obs with a bedside commode, but observation beds are not required to have individual bathrooms like inpatient beds.



Inclusion Criteria

  • Acceptable VS
  • Mild to moderate dehydration
  • Self-limiting or treatable cause not requiring hospitalization
  • Mild to moderate electrolyte abnormalities
  • Evidence of dehydration – vomiting / diarrhea, high BUN/Cr ratio, orthostatic changes, poor skin turgor, high urine specific gravity, hemoconcentration, etc.
  • Hyperemesis Gravidarum (Should consult Ob/Gyn prior to transfer)

Exclusion Criteria

  • Dehydration is not clearly present
  • Unstable VS (hypotension, tachycardia, severe dehydration)
  • Cardiovascular compromise
  • Severe (>15%) dehydration
  • Severe electrolyte abnormalities
  • Associated cause not amenable to short term treatment: bowel obstruction, appendicitis, bowel ischemia, DTs, DKA, sepsis, etc.

Potential Interventions

  • IV hydration (D5LR if hyperemesis gravidarum)
  • Serial exams, monitor intake and output, vital signs
  • Antiemetic administration

Discharge Criteria

Home

    • Acceptable VS
    • Resolution of symptoms, able to tolerate oral fluids
    • Normal electrolytes (if done)

Admit

    • Unstable VS
    • Associated cause found requiring hospitalization
    • Inability to tolerate oral fluids

Most-Commented

No records to display